Mobile clinics are often used to provide primary care in crises where access to services has been severed due to widespread infrastructural damage, safety concerns, or inadequate capacity to address specific higher-level care services such as HIV. Recently, the WHO has implemented clinics in Iraq, Jordan, Syria, Ukraine, and Yemen. In each setting, the supply of vans and equipment, as well as partnerships with local providers, differs according to existing infrastructure.1 However, mobile clinics have also been implemented in non-acute settings to provide continuous access to care in places where geographic access poses a barrier to PHC. In Kazakhstan, the Ministry of Health partnered with the Committee of Emergency Situations within the Ministry of Internal Affairs to develop three train-based clinics. Each train comprises eight wagons with clinical, diagnostic, and radiology equipment. Thirty-six medical staff including 18 specialists work in conjunction with 44 operations personnel to provide care in 832 stations on a rotation of approximately 20 days.2 Between 2010 and 2014, the trains have provided care to nearly 37,000 individuals who would otherwise have limited access to primary health care. This intervention demonstrates creative use of existing infrastructure to deliver care to remote populations. While mobile clinics are commonly implemented in crises, and – as in the Kazakhstan case study – may be capable of providing pre-scheduled and non-urgent care, a mobile and thus intermittent system is unable to provide first-contact, continuous, and comprehensive care and may not be a reasonable option for sustainable PHC system strengthening.

References:

  1. Mobile clinics provide health care to people in some of the world’s worst crises. The World Health Organization.
  2. Kulkayeva G. Using medical trains to improve access to health services across Kazakhstan. WHO collaborating centre for Integrated Health Services based on Primary Care. 2016.